The Incarcerated and Brain Injuries

Anna Sage
JBBS Case Manager and Mental Health Professional
photo by Annie Uyehara

The Incarcerated and Brain Injuries

By Annie Uyehara

NOTE: This is the second installation of a two part series on people with brain injuries. Last month we wrote of the challenge of having a brain injury and the Brain Injury Alliance of Colorado (BIAC).

Imagine telling a judge that you have no recollection of doing anything wrong but still find yourself behind bars. 

This may sound like an excuse, but people with brain injuries often do not recall what they’ve done or even that it’s criminal, yet end up incarcerated.

“A lot of the incarcerated have had a brain injury, so it can be very frustrating for the judicial system to understand what [people with Traumatic Brain Injury (TBI)] are going through,” says Audrey McNeely, Navigator and Advisor at the Brain Injury Alliance of Colorado (BIAC). “For those with brain injuries to say to a judge, ‘I can’t remember,’ doesn’t seem adequate, and it’s not met with understanding. There’s a big challenge then, in the legal system.”

BIAC—which offers therapy, support groups, skills building and other resources for those with TBI—is available to judicial systems, but McNeely emphasizes that BIAC cannot diagnose nor give legal representation for the TBI incarcerated. “We can educate the lawyers, courts, judges, and detention centers, but they have to reach out to us. We are very open to offering them information and professional training to better understand TBIs within the incarcerated population. The more educated we are, the better off they are.”

Behavioral health therapists also work within the judicial system, such as Anna Sage, who works in the Garfield County jail. She is a Jail Based Behavioral Services (JBBS) case manager and mental health professional who also does work for Correctional Health Partners. Her caseload includes two incarcerated clients with TBI.

Sage helps the TBI incarcerated with resources, therapy and coping skills. The most frequent mental issues she sees are anxiety, depression and confusion. “People with TBI don’t remember things well. I also see a lot of anger issues because they process things differently,” says Sage, explaining why some may find themselves in jail. “They need someone who is patient and will repeat information for them. Sometimes, I just listen to them and let them vent; it helps them process their feelings, especially if they’re not expecting to be incarcerated. They may not even understand the charges against them.”

Like McNeely, Sage believes education is key: The better educated people are, the better chance the TBI incarcerated have of being understood by the judicial system and the general population. 

“It’s not something people talk about, they’d rather sweep it under the rug—if we can’t see it, it doesn’t exist,” Sage says is a common response to people with TBI. 

Yet, there are blessings working with the TBI incarcerated, she says. “I remember a recent experience when a client was able to finally calm down and think a little better. Or I will get a little smile back, a little thank you, and that’s really welcoming, that’s where I see what I’m doing is working.”


For more information about training and education on TBI within the judicial system, contact Liam Donevan at BIAC: 303-562-3298

Correctional Health Partners, contact 1-866-932-7185


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